Saleh Farid, Palmieri Beniamino, Lodi Danielle, Al-Sebeih Khalid
Department of Anatomy, Faculty of Medicine, Health Science Centre, Kuwait University, Kuwait.
Int J Med Sci. 2008;5(6):354-60. doi: 10.7150/ijms.5.354. Epub 2008 Nov 11.
The increasing number of surgical procedures performed with local anesthesia, followed by immediate patient discharge from the hospital, emphasizes the need for a tight waterproof suture that is capable of maintaining its tensile strength in the postoperative phase when the wound tumescence, edema due to the anesthetic drug, and surgical trauma disappear. Moreover, the issue of having an accurate surgical wound closure is very relevant in vivo in order to prevent hemorrhage and exogenous microbial infections. This study aimed at designing a new a lab technique that could be used for evaluating the best surgical material. Using such a technique, we compared the wound-lip-sealing properties of three commonly-used suture threads, namely polyurethane, polypropylene, and polyamide.
The mechanical properties of same-size suture threads made from polyurethane, polypropylene, and polyamide, were compared in order to define the one that possess the best elastic properties by being able to counteract the tension-relaxation process in the first 12 hours following surgery. The tension holding capacity of the suture materials was measured in both in vivo and in vitro experiments. The surface area of the scar associated with the three different suture threads was measured and compared, and the permeability of the three different suture threads was assessed at 0 minute, 2 minute, 4 minute, 6 minute, and 8 minute- interval.
Results showed that polyurethane suture threads had significantly (P < 0.05) better tensile strength, elongation endurance before breakage, and better elasticity coefficient as compared to polypropylene and polyamide suture threads. Moreover, polyurethane suture threads were significantly (P < 0.05) more impermeable as compared to the other two suture thread types (polypropylene and polyamide). This impermeability was also associated with a tighter wound-lip-sealing ability, and with significantly (P < 0.05) less scar formation.
Among the main concerns that surgeons, physicians, and patients often have is the development infection, oozing, and scar at the incision site following suturing. This always raises the question about which suture to use to avoid the above problems. This study provides evidence that the new technique developed in our lab could be used to compare the wound-lip sealing properties of different surgical suture threads. Using such a technique, the results show that polyurethane is significantly better than other commonly-used suture threads, like polypropylene and polyamide, in relation to wound sealing and scar formation.
随着局部麻醉下进行的外科手术数量不断增加，且患者术后随即出院，这凸显了对一种紧密防水缝线的需求，该缝线需在术后伤口肿胀、因麻醉药物引起的水肿以及手术创伤消退时仍能保持其拉伸强度。此外，为防止出血和外部微生物感染，准确进行手术伤口闭合这一问题在体内非常关键。本研究旨在设计一种可用于评估最佳手术材料的新实验室技术。利用该技术，我们比较了三种常用缝线，即聚氨酯、聚丙烯和聚酰胺的伤口边缘密封性能。
比较由聚氨酯、聚丙烯和聚酰胺制成的相同尺寸缝线的机械性能，以确定能够在术后最初12小时内抵消张力松弛过程、具有最佳弹性性能的缝线。在体内和体外实验中均测量了缝线材料的张力保持能力。测量并比较了与三种不同缝线相关的瘢痕表面积，并在0分钟、2分钟、4分钟、6分钟和8分钟的间隔时间评估了三种不同缝线的渗透性。
结果显示，与聚丙烯和聚酰胺缝线相比，聚氨酯缝线具有显著更好的拉伸强度、断裂前伸长耐久性以及更好的弹性系数（P < 0.05）。此外，与其他两种缝线类型（聚丙烯和聚酰胺）相比，聚氨酯缝线的渗透性显著更低（P < 0.05）。这种低渗透性还与更紧密的伤口边缘密封能力相关，且瘢痕形成显著更少（P < 0.05）。
外科医生、内科医生和患者通常主要关心的问题之一是缝合后切口部位出现感染、渗液和瘢痕。这总是引发关于使用哪种缝线来避免上述问题的疑问。本研究提供了证据表明，我们实验室开发的新技术可用于比较不同手术缝线的伤口边缘密封性能。利用该技术，结果表明在伤口密封和瘢痕形成方面，聚氨酯明显优于其他常用缝线，如聚丙烯和聚酰胺。
